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THE CAHPS DATABASE

2013 CAHPS Health Plan Survey Database




2013 Chartbook: What Consumers Say About Their Experiences with Their Health Plans and Medical Care




AHRQ Contract No.: HHSA290201300003C

Managed and prepared by:

Westat, Rockville, MD

Dale Shaller
Janice Ricketts
Michael Hornbostel

AHQR Publication No. 14-0017-EF
November 2013




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This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without specific permission of copyright holders.

No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in this report.


Table of contents

1. INTRODUCTION

2. SELECTED HIGHLIGHTS

3. DATA SOURCES AND LIMITATIONS

4. COMPARATIVE RESULTS

Getting Needed Care

Getting Care Quickly

How Well Doctors Communicate

Health Plan Information and Customer Service

Rating of Personal Doctor

Rating of Specialists

Rating of Health Care

Rating of Health Plan

Tables

Table 1-1. Comparison of 2013 Top-Box Scores By Survey Population

Table 3-1. Survey Respondents and Health Plan Samples: 2011 and 2013


Appendixes

Appendix A. About the CAHPS Health Plan Survey Database

Appendix B. Composition of the CAHPS Health Plan Survey Database: 1998-2013

Appendix C. Survey Respondents and Health Plan Samples by State: 2011 and 2013

Appendix D. Definition of Regions

Appendix E. Definition of Composites and Items and Ratings

1. INTRODUCTION

Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys ask consumers about their experiences with health care. The CAHPS program at the U.S. Agency for Healthcare Research and Quality (AHRQ) supports the development and promotion of CAHPS surveys, toolkit materials, and comparative databases, and provides technical assistance to users. Learn more about AHRQ’s CAHPS program at: www.cahps.ahrq.gov.

AHRQ’s CAHPS Database receives data voluntarily submitted by users that have administered the CAHPS Health Plan Survey. The CAHPS Database aggregates the data to facilitate comparisons of CAHPS survey results by users, researchers, and other interested organizations.

This Chartbook presents summary-level results for the CAHPS Health Plan Survey 5.0 version for 2013 and 4.0 version for 2011. For 2013, 692 Medicaid and Medicare health plans are included covering 334,552 respondents and for 2011 763 health plans are included covering 348,237 respondents. Results for the core survey composites and ratings are presented in the form of comparative bar charts for the following health plan enrollee populations:

  • Adult Medicaid
  • Child Medicaid
  • CHIP (Children's Health Insurance Program)
  • Medicare Managed Care

The summary results presented in this Chartbook are compiled from detailed data displays reported in the CAHPS Database Online Reporting System (ORS) at https://www.cahpsdatabase.ahrq.gov/CAHPSIDB/Public/about.aspx.

The CAHPS Database ORS consists of both a public site and a private submitter’s site available only to survey users that contribute data. Survey users that submit data to the CAHPS Health Plan Survey Database are provided access to a secure, password-protected area of the online reporting system that allows them to compare their own results to selected comparative results.

Both the ORS public site and the submitter’s site present CAHPS Health Plan Survey results for composite measures, ratings, and individual survey items, organized according to survey version and field period. Displays available through the various tabs include “top box” scores, frequencies, bar charts, and percentiles. The “report builder” feature allows users to create and download custom reports on demand.

Research files for the CAHPS Health Plan Survey data presented in this Chartbook, as well as from the 2000-2010 CAHPS Health Plan Databases, are available upon request according to the CAHPS Database Data Release Policy. (To learn more, visit https://cahpsdatabase.ahrq.gov/DataResearchers.aspx)

The CAHPS Database Online Reporting System will be updated periodically with new data submitted by CAHPS Health Plan survey users. Questions or comments regarding this Chartbook or any aspect of the CAHPS Health Plan Survey Database may be directed to the CAHPS Database toll-free help line at 888-808-7108 or by email to CAHPSDatabase@westat.com

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2. SELECTED HIGHLIGHTS

Comparisons by Sector

The following table presents a comparison of top-box scores (the most positive survey response) for the composites and ratings across the four health plan enrollee populations included in the 2013 CAHPS Health Plan Survey Database.

Table 1-1. Comparison of 2013 Top-Box Scores By Survey Population
Composite/Rating Adult
Medicaid		 Child
Medicaid		 CHIP Medicare
Getting Needed Care 52% 57% 57% 66%
Getting Care Quickly 57% 70% 72% 66%
How Well Doctors Communicate 71% 74% 76% 77%
Health Plan Information and Customer Service 65% 65% 61% 68%
Rating of Personal Doctor 64% 72% 72% 75%
Rating of Specialist 64% 69% 67% 71%
Rating of Health Care 51% 63% 63% 62%
Rating of Health Plan 56% 66% 63% 63%

Selected highlights from this comparison include:

  • The highest scoring composite across all sectors is How Well Doctors Communicate. The lowest scoring composite is Getting Needed Care.
  • The highest scoring rating across all sectors is Personal Doctor. The lowest scoring overall rating is Health Care.
  • Scores for the Child Medicaid and CHIP sectors are higher than the Adult Medicaid sector for all composites and ratings except for Health Plan Information and Customer Service.
  • Scores for the Medicare sector are higher than the other sectors except for the Child Medicaid and CHIP scores for Getting Care Quickly and Health Care and Health Plan overall ratings.

Comparisons by Year

The bar charts in this report and the ORS compare results for both 2013 and 2011. Because the data sources for the 2 years are not the same, the results for these two years are not directly comparable. However, it is notable that many of the composite and rating results show a slight increase between 2011 and 2013.

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3. DATA SOURCES AND LIMITATIONS

The data presented in this Chartbook were compiled from CAHPS Health Plan Survey results submitted to the CAHPS Database by various survey sponsors, including State Medicaid agencies, CHIP programs, individual health plans, and the Medicare program. As noted above, differences in the mix of sponsors contributing data from year to year do not support direct comparisons over time. Comparison of results across sectors also should be made with caution, since significant variations may exist in benefit design and other factors that might affect survey responses across sector.

Table 3-1 presents the number of Medicaid, CHIP, and Medicare survey respondents and health plan samples included in the CAHPS Health Plan Survey Database for 2013 and 2011. The number of health plan samples is indicated in parentheses.

Table 3-1. Survey Respondents and Health Plan Samples: 2013 and 20111
Year
(CAHPS Version) 		Commercial2 Commercial Medicaid Medicaid CHIP Medicare
Adult Child Adult Childt Child Adult
2013 (5.0) N/A N/A 60,249 (124) 66,804 (105) 9,149 (12) 198,350 (451)
2011 (4.0) 168,341 (376) 900 (1) 73,820 (148) 85,003 (129) 26,232 (41) 163,182 (445)

1The contract that supports the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program expired during 2012 and a new contract was awarded in 2013, therefore the CAHPS Database does not include CAHPS Health Plan Survey data for 2012.
2Survey results for the commercial sector are no longer included in the CAHPS Health Plan Survey Database.

  • Medicaid Data and CHIP Data: The survey results for the Medicaid and CHIP sectors were obtained from data submitted directly to the CAHPS Database by State Medicaid agencies and individual health plans. The 2013 results are based on survey data collected between September 2012 and June 2013. The 2011 results are based on survey data collected between September 2010 and June 2011.
  • Medicare Data: Each year, the CAHPS Database receives the CAHPS Medicare Managed Care survey data collected by the Centers for Medicare & Medicaid Services (CMS). These results are for survey participants enrolled in a managed care health plan including both enrollees receiving prescription drug coverage through their health plan and those that do not receive prescription drug coverage through their health plan. The Medicare results presented here may differ from other reports due to the inclusion or exclusion of certain beneficiary groups and/or the use of case-mix adjustment variables. The survey data were collected from February through June for both years.

Appendix B summarizes the composition of the CAHPS Health Plan Survey Database over the since its inception in 1998. Appendix C presents the number of Medicaid, CHIP, and Medicare survey respondents and health plan samples included in the CAHPS Database for 2011 and 2013 by State.

The contract that supports the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program expired during 2012 and a new contract was awarded in 2013, therefore the CAHPS Database does not include CAHPS Health Plan Survey data for 2012.

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4. COMPARATIVE RESULTS

This section presents a summary of comparative results for each of the health plan enrollee populations included in the 2013 and 2011 CAHPS Health Plan Survey Database. Results are presented in the form of bar charts that graphically show the distribution of scores for the four composites and four ratings.

The bar charts are composed of colored segments that show the percentage of responses in each of the response categories. For questions and composites based on 4-point response scales (i.e., "always", "usually", "sometimes", "never"), the bottom segment combines the two lowest response categories (i.e., "sometimes" and "never").

All results presented in these charts are calculated at the respondent level. Survey results are presented in the following order:

  • Getting Needed Care
  • Getting Care Quickly
  • How Well Doctors Communicate
  • Health Plan Information and Customer Service
  • Rating of Personal Doctor
  • Rating of Specialist
  • Rating of Health Care
  • Rating of Health Plan

As noted earlier, detailed results for each question item are available through the CAHPS Database Online Reporting System at https://www.cahpsdatabase.ahrq.gov/CAHPSIDB/Public/about.aspx.

Getting Needed Care

Combines responses from two questions regarding how easily consumers got various aspects of needed care.

Never + SometimesUsuallyAlways

Scale
Medicaid
20%28%52%
2013 Adult Medicaid(n=42,801)
22%27%51%
2011 Adult Medicaid(n=42,545)

18%25%57%
2013 Child Medicaid(n=45,366)
21%24%55%
2011 Child Medicaid(n=33,630)

16%27%57%
2013 CHIP(n=5,087)
20%25%54%
2011 CHIP(n=8,595)

Medicare
9%24%66%
2013 Medicare(n=130,949)
9%26%65%
2011 Medicare(n=114,692)

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Getting Care Quickly

Combines responses from two questions regarding how often consumers received various types of care in a timely manner.



Never + SometimesUsuallyAlways

Scale
Medicaid
19%24%57%
2013 Adult Medicaid(n=44,723)
19%25%56%
2011 Adult Medicaid(n=56,005)

13%17%70%
2013 Child Medicaid(n=49,535)
13%16%71%
2011 Child Medicaid(n=63,178)

11%17%72%
2013 CHIP(n=6,404)
14%19%67%
2011 CHIP(n=16,819)

Medicare
11%23%66%
2013 Medicare(n=153,182)
11%23%66%
2011 Medicare(n=128,564)

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How Well Doctors Communicate

Combines responses from four questions regarding how often doctors communicated well with consumers.

Scale
Medicaid
10%19%71%
2013 Adult Medicaid(n=37,204)
11%19%70%
2011 Adult Medicaid(n=46,558)

8%18%74%
2013 Child Medicaid(n=42,858)
8%17%75%
2011 Child Medicaid(n=58,249)

5%19%76%
2013 CHIP(n=5,544)
8%21%71%
2011 CHIP(n=15,245)

Medicare
5%18%77%
2013 Medicare(n=155,160)
5%19%76%
2011 Medicare(n=128,142)

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Health Plan Information and Customer Service

Combines responses from two questions about health plan information and customer service from the consumer’s health plan.


Never + SometimesUsuallyAlways

Scale
Medicaid
14%21%65%
2013 Adult Medicaid(n=16,872)
20%21%60%
2011 Adult Medicaid(n=17,383)

13%22%65%
2013 Child Medicaid(n=18,074)
20%20%60%
2011 Child Medicaid(n=13,654)

14%25%61%
2013 CHIP(n=2,493)
19%24%57%
2011 CHIP(n=4,379)

Medicare
12%20%68%
2013 Medicare(n=54,539)
12%21%67%
2011 Medicare(n=46,551)

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Rating of Personal Doctor

Using 0 to 10, where 0 is worst possible and 10 is best possible, how consumers rated their personal doctor.
Never + SometimesUsuallyAlways

0-67-89-10

Scale
Medicaid
13%23%64%
2013 Adult Medicaid(n=44,185)
15%23%63%
2011 Adult Medicaid(n=55,157)

7%20%72%
2013 Child Medicaid(n=52,170)
9%21%70%
2011 Child Medicaid(n=70,384)

6%22%72%
2013 CHIP(n=7,167)
7%24%69%
2011 CHIP(n=19,815)

Medicare
6%18%75%
2013 Medicare(n=155,907)
7%17%76%
2011 Medicare(n=126,721)

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Rating of Specialists

Using 0 to 10, where 0 is worst possible and 10 is best possible, how consumers rated the specialist they saw most often.

Scale
Medicaid
13%23%64%
2013 Adult Medicaid(n=21,053)
15%23%62%
2011 Adult Medicaid(n=24,749)

9%22%69%
2013 Child Medicaid(n=12,792)
11%23%66%
2011 Child Medicaid(n=16,992)

9%24%67%
2013 CHIP(n=1,626)
11%23%66%
2011 CHIP(n=3,871)

Medicare
8%21%71%
2013 Medicare(n=104,610)
8%19%73%
2011 Medicare(n=84,677)

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Rating of Health Care

Using 0 to 10, where 0 is worst possible and 10 is best possible, how consumers rated their health care.

0-67-89-10

Scale
Medicaid
18%31%51%
2013 Adult Medicaid(n=42,522)
20%31%49%
2011 Adult Medicaid(n=53,139)

10%27%63%
2013 Child Medicaid(n=46,830)
10%28%61%
2011 Child Medicaid(n=61,921)

8%29%63%
2013 CHIP(n=6,191)
9%29%61%
2011 CHIP(n=16,901)

Medicare
12%26%62%
2013 Medicare(n=187,837)
12%26%62%
2011 Medicare(n=155,063)

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Rating of Health Plan

Using 0 to 10, where 0 is worst possible and 10 is best possible, how consumers rated their health plan.
0-67-89-10

Scale
Medicaid
16%28%56%
2013 Adult Medicaid(n=53,713)
18%28%54%
2011 Adult Medicaid(n=67,085)

10%24%66%
2013 Child Medicaid(n=60,827)
10%25%64%
2011 Child Medicaid(n=79,304)

9%27%63%
2013 CHIP(n=8,523)
8%24%68%
2011 CHIP(n=24,862)

Medicare
11%26%63%
2013 Medicare(n=186,569)
12%26%62%
2011 Medicare(n=154,743)

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Appendix A. About the CAHPS Health Plan Survey Database

CAHPS Database

The CAHPS Database is the repository for data from selected CAHPS surveys. The primary purpose of the CAHPS Database is to facilitate comparisons of CAHPS survey results by survey users. This voluntary compilation of survey results from a large pool of data into a single database enables survey users to compare their own results to relevant reference points such as overall and regional averages. The CAHPS Database also offers an important source of primary data for research related to consumer assessments of quality as measured by CAHPS surveys.

CAHPS Health Plan Survey Database

The CAHPS Health Plan Survey Database currently contains data since 1998 from over 5.6 million respondents sampled from enrollees in commercial, Medicaid, Children’s Health Insurance Program (CHIP), and Medicare Managed Care health plans.

CAHPS Database Online Reporting System

The CAHPS Database Online Reporting System is a Web-based platform for viewing CAHPS Health Plan Survey and Clinician & Group Survey results. The reporting system consists of two major components: (1) a public site available to anyone with access to the Internet and (2) a submitter’s site available only to survey users that contribute data.

Public Site

The public site presents a variety of CG-CAHPS survey results such as composite measures and individual survey items, organized according to overall, regional and product-type distributions. Displays include the following:

  • "Top Box" Scores: Displays the percentage of respondents reporting the most positive response for a composite, rating, or question item. Top box scores are presented for several practice characteristics, such as region, physician specialty, practice ownership, and survey mode. Top box scores are also presented for the 90th, 75th, 50th, and 25th percentiles (i.e., the percentage of practice sites that scored at or below a particular top box score).
  • Frequencies: Displays one-way frequency tables of the distribution of scores (by percent and number of respondents) for all response options. Two-way frequency tables display the distribution of scores for all response options for selected respondent and practice characteristics.
  • Bar charts: Displays a graphical distribution of survey results that show the top, bottom, and middle response categories. Bar charts present results for the database overall distribution as well as for selected practice characteristics.
  • Trending: Displays the two most recent years of data for composites, overall ratings and individual survey items.
  • Chartbook: Displays cross-sector comparisons of the CAHPS Health Plan Survey results for Medicaid (adult and child), CHIP (child), and Medicare (adult) populations for the two most recent years.
  • Percentiles: Displays the percentage of health plans that scored at or below a particular top box score.
  • Report builder: The report builder feature allows users to create custom reports on demand, consisting of all results of interest.

Submitter’s Site

Survey users that submit data to the CAHPS Health Plan Database are provided access to a secure, password-protected area of the online reporting system that allows them to compare their own results to selected comparative results. This secure site has all of the features of the public site, with the added benefit of viewing the individual health plans scores that have been contributed by the submitting sponsor organization. In addition, the bar chart feature on the submitter’s site shows tests of statistical differences for individual health plan scores. A report manager function allows the submitter to share secure results with other users if they choose.

Research Files

Researchers may gain authorized access to de-identified data files from the CAHPS Health Plan Database to help answer important health services research questions related to patient experience of care as measured by CAHPS. CAHPS Health Plan Survey data may be granted to researchers who submit an application and sign a data use agreement that ensures the confidentiality of the data. A description of the data application process is at https://cahpsdatabase.ahrq.gov/DataResearchers.aspx.

In addition, the CAHPS Database provides data used by policymakers and others through such publications as the AHRQ National Healthcare Quality and Disparities Reports.

Participating in the CAHPS Health Plan Database

Participation in the CAHPS Health Plan Database is free and open to all survey users on a voluntary basis. There is no charge to participate. All health plans, State Medicaid agencies and survey vendors who choose to participate provide the CAHPS Database with the following:

  • Respondent-level survey data
  • Health plan characteristics
  • Other information regarding the sampled population and survey administration
  • A signed Data Use Agreement

The only requirement for participation is conformance with standard data submission specifications developed for the CAHPS Health Plan Survey. Specifications for submitting data files and other information required for participation are available at https://cahpsdatabase.ahrq.gov/submissionHP.aspx.

Administration

The CAHPS Database is sponsored and funded by the Agency for Healthcare Research and Quality (AHRQ) and administered by Westat. Oversight and direction for the Database are provided by an Advisory Group composed of representatives of survey users from the public and private sectors as well as members of the CAHPS Consortium. Further information about the CAHPS Database is available at https://cahpsdatabase.ahrq.gov.

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Appendix B. Composition of the CAHPS Health Plan Survey Database: 1998-2013

The CAHPS Database currently contains 15 years of data from the CAHPS Health Plan Survey. The table shows data submissions to the CAHPS Database from 1998 to 2013. The total number of respondents is presented by population sector, with the number of health plan samples in parentheses.

Table B-1. Composition of the CAHPS Health Plan Survey Database 1998-2013 by Survey Version
Year
(CAHPS Version) 		Commercial1 Commercial Medicaid Medicaid CHIP Medicare
Adult Child Adult Child Child Adult
2013 (5.0) N/A N/A 60,249 (124) 66,804 (105) 9,149 (12) 198,350 (451)
2011 (4.0) 168,341 (376) 900 (1) 73,820 (148) 85,003 (129) 26,232 (41) 163,182 (445)
2010 (4.0) 139,156 (288) 1,474 (2) 97,626 (132) 88,694 (132) 0 (0) 221,120 (431)
2009 (4.0) 179,528 (405) 751 (2) 63,391 (126) 68,697 (107) 0 (0) 206,647 (405)
2008 (4.0) 174,307 (410) 0 (0) 59,840 (120) 9,755 (29) 0 (0) 207,366 (343)
2008 (3.0) 0 (0) 1,882 (4) 0 (0) 37,347 (64) 0 (0) 0 (0)
2007 (4.0) 106,811 (239) 0 (0) 45,979 (109) 4,647 (16) 0 (0) 115,910 (296)
2007 (3.0) 0 (0) 1,659 (4) 0 (0) 64,039 (103) 0 (0) 0 (0)
2006 (3.0) 124,585 (271) 2,400 (7) 43,174 (119) 50,204 (95) 9,303 (30) 97,955 (273)
2005 (3.0) 123,272 (254) 2,661 (4) 32,115 (76) 40,204 (65) 1,252 (3) 127,930 (276)
2004 (3.0) 111,680 (223) 7,024 (12) 59,515 (149) 86,159 (128) 16,657 (29) 132,420 (288)
2003 (3.0) 114,063 (216) 1,866 (4) 39,275 (112) 31,081 (69) 19,061 (49) 141,421 (295)
2002 (2.0) 94,546 (219) 5,600 (10) 48,109 (136) 60,534 (122) 18,910 (43) 153,172 (321)
2001 (2.0) 165,500 (266) 9,913 (24) 45,127 (142) 36,940 (124) 0 (0) 179,451 (381)
2000 (2.0) 135,479 (270) 2,760 (8) 49,327 (156) 451,400 (140) 0 (0) 166,072 (367)
1999 (2.0) 168,234 (307) 42,979 (149) 28,420 (77) 14,106 (66) 0 (0) 0 (0)
1998 (1.0) 34,965 (54) 0 (0) 23,519 (31) 9,871 (33) 0 (0) 0 (0)
Totals 1,840,467 81,769 709,237 728,681 91,415 1,912,646

1Survey results for the commercial sector are no longer included in the CAHPS Health Plan Survey Database

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Appendix C. Survey Respondents and Health Plan Samples by State: 2011 and 2013

Table C-1 and Table C-2 show data submissions to the CAHPS Database by State for 2013 and 2011, respectively. The total number of respondents is presented by population sector, with the number of health plan samples given in parentheses.

Table C-1. 2013 Survey Respondents and Health Plan Samples by State (5.0 Results)
State Medicaid Medicaid CHIP Medicare
Adult Child Child Adult
Alabama - - 879 (1) 2,271 (5)
Arizona - - - 7,924 (18)
Arkansas - - - 1,091 (3)
California 15,077 (28) 19,447 (26) - 17,748 (33)
Colorado 1,090 (2) 3,361 (3) 3,444 (6) 4,552 (10)
Connecticut - - - 2,575 (7)
Delaware - - - 871 (2)
District Of Columbia - 1,041 (1) - -
Florida 1,034 (4) - - 11,362 (33)
Georgia - - - 5,447 (15)
Hawaii - 2,972 (7) 876 (1) 4,207 (9)
Idaho - - - 2,305 (5)
Illinois 395 (1) 515 (1) - 4,801 (10)
Indiana 1,878 (3) 1,520 (2) - 2,008 (5)
Iowa - - - 2,232 (4)
Kansas - - - 436 (1)
Kentucky - - - 1,056 (3)
Louisiana - - - 2,874 (5)
Maine - - - 3,132 (5)
Maryland 3,704 (7) 7,008 (7) - 1,781 (4)
Massachusetts 2,208 (5) - - 4,608 (10)
Michigan 5,724 (12) - - 5,966 (11)
Minnesota 9,992 (9) - - 4,945 (12)
Mississippi - - - 5,826 (3)
Missouri - - - 5,074 (12)
Montana - - - 628 (1)
Nebraska - - - 1,641 (4)
Nevada - - - 2,868 (7)
New Jersey 3,818 (19) 3,495 (13) - 2,735 (8)
New Mexico 1,296 (3) 1,438 (2) - 3,253 (8)
New York 1,424 (3) 7,071 (17) 2,361 (1) 13,097 (33)
North Carolina - - - 2,594 (7)
Ohio 3,403 (7) 8,405 (7) - 7,650 (20)
Oklahoma - 1,206 (1) - 1,939 (5)
Oregon - - - 9,345 (18)
Pennsylvania 3,506 (8) 4,092 (8) 638 (1) 9,881 (22)
Puerto Rico 662 (1) - - 5,226 (12)
Rhode Island 493 (1) - - 731 (2)
South Carolina 447 (1) 476 (1) - 1,895 (5)
Tennessee - - - 3,527 (8)
Texas - 370 (1) 450 (1) 8,446 (24)
Utah 381 (1) - 501 (1) 3,113 (7)
Virginia 2,598 (6) 3,325 (6) - 2,640 (6)
Washington 501 (1) - - 4,128 (11)
West Virginia 298 (1) 538 (1) - 1,972 (5)
Wisconsin 320 (1) 524 (1) - 5,949 (13)
Totals 60,249 (124) 66,804 (105) 9,149 (12) 198,350 (451)
Table C-2. 2011 Survey Respondents and Health Plan Samples by State (4.0 Results)
State Commercial Commercial Medicaid Medicaid CHIP Medicare
Adult Child Adult Child Child Adult
Alabama 317 (1) - - - 997 (1) 1,849 (5)
Arizona 997 (2) - 532 (1) 585 (1) - 6,268 (18)
Arkansas 917 (2) - 482 (1) 452 (1) 516 (1) 1,948 (5)
California 14,930 (23) - 3,030 (5) 3,376 (3) 12,222 (24) 10,526 (32)
Colorado 2,965 (6) - 1,963 (4) 2,730 (4) 2,833 (5) 3,646 (9)
Connecticut 45,539 (118) - 982 (2) 966 (1) - 2,418 (7)
Delaware 1,506 (3) - 422 (1) 399 (1) 325 (1) 871 (2)
District Of Columbia - - 439 (1) 1,212 (2) - -
Florida 3,472 (8) - 4,193 (14) 5,036 (15) - 10,200 (32)
Georgia 7,491 (20) - - - - 5,030 (14)
Hawaii 4,313 (4) - - 3,018 (5) - 2,157 (6)
Idaho - - - - - 1,691 (4)
Illinois 9,825 (24 - - - - 3,806 (10)
Indiana 1,661 (4) - 1,568 (3) 1,453 (2) - 2,639 (6)
Iowa 1,062 (2) - - - 898 (1) 1,881 (4)
Kansas 759 (2) 368 (1) 1,312 (1) 1,098 (1) 346 (1)
Kentucky 4,268 (11) - - - - 1,555 (4)
Louisiana 1,942 (5) - - - - 2,217 (6)
Maine 1,385 (2) - - - - 1,997 (4)
Maryland 1,395 (3) - 3,766 (7) 7,207 (7) - 2,061 (5)
Massachusetts 4,657 (10) - 2,475 (5) - - 2,977 (9)
Michigan 4,242 (8) - 6,891 (14) 6,701 (14) - 4,198 (10)
Minnesota 2,070 (4) - 10,862 (8) - - 5,300 (13)
Mississippi - - - - 950 (1) 706 (2)
Missouri 2,994 (7) - 1,345 (3) 4,097 (4) 1,612 (1) 5,164 (13)
Montana - - - - - 487 (1)
Nebraska 480 (1) - 506 (1) - - 1,225 (3)
Nevada 832 (2 - - - - 2,720 (7)
New Hampshire 435 (1) - - - - -
New Jersey 1,492 (3) - 3,804 (14) 5,845 (14) - 2,665 (9)
New Mexico 2,131 (5) - 1,796 (4) 2,730 (3) - 2,408 (7)
New York 8,904 (21) - 1,437 (3) - - 12,881 (37)
North Carolina 881 (2) - - - - 2,662 (7)
Ohio 5,892 (12) - 8,025 (11) 9,781 (7) - 7,331 (19)
Oklahoma 382 (1) - - 613 (1) - 1,913 (5)
Oregon 2,872 (6) - 6,525 (17) 6,607 (17) - 6,398 (16)
Pennsylvania 4,471 (10) - 3,044 (6) 3,426 (6) 904 (1) 7,149 (20)
Puerto Rico - - 359 (1) - - 4,055 (13)
Rhode Island - - 1,091 (2) 594 (1) - 1,122 (3)
South Dakota 487 (1) - 972 (2) 1,190 (2) - 1,452 (4)
South Dakota 416 (1) - - - - 377 (1)
Tennessee 730 (2) - 2,694 (6) 6,626 (6) 1,748 (1) 3,535 (10)
Texas 3,122 (9) - 521 (2) 1,492 (2) 1,543 (2) 7,912 (24)
Utah 791 (2) 900 (1) 429 (1) - 586 (1) 2,847 (7)
Vermont 1,901 (3) - - - - -
Virginia 2,467 (5) - 2,155 (5) 4,891 (5) - 1,397 (4)
Washington 3,022 (5) - 436 (1) 850 (1) - 4,767 (12)
West Virginia 427 (1) - 708 (2) 1,074 (2) - 1,119 (3)
Wisconsin 7,499 (14) - - 740 (1) - 5,753 (13)
Totals 168,341 (376) 900 (1) 73,820 (148) 85,003 (129) 26,232 (41) 163,182 (445)

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Appendix D. Definition of Regions

The regional comparative resultss are calculated according to the United States Census Bureau’s four official regions, as show in Table D-1.

Table D-1. Composites and Rating Items for 5.0 Version of CAHPS Health Plan Survey
Region States
Northeast Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Puerto Rico, Rhode Island, Vermont
Midwest Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin
South Alabama, Arkansas, Delaware, DC, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia
West Alaska, Arizona, California, Colorado, Guam, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming

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Appendix E. Definition of Composites and Items and Ratings

Table E-1 presents the composites and individual items and ratings items for the 5.0 version of the CAHPS Health Plan Survey.

Table E-1. Composites and Rating Items for 5.0 Version of CAHPS Health Plan Survey
Question Text Response Option
Getting Needed Care
In the last 6 months, how often did you get an appointment to see a specialist as soon as you needed? Never - Always
In the last 6 months, how often was it easy to get the care, tests, or treatment you needed? Never - Always
Getting Care Quickly
In the last 6 months, when you needed care right away, how often did you get care as soon as you needed? Never - Always
In the last 6 months, how often did you get an appointment for a check-up or routine care at a doctor's office or clinic as soon as you needed? Never - Always
How Well Doctors Communicate
In the last 6 months, how often did your personal doctor explain things in a way that was easy to understand? Never - Always
In the last 6 months, how often did your personal doctor show respect for what you had to say? Never - Always
In the last 6 months, how often did your personal doctor spend enough time with you? Never - Always
In the last 6 months, how often did your personal doctor listen carefully to you? Never - Always
Health Plan Information & Customer Service
In the last 6 months, how often did your health plan’s customer service give you the information or help you needed? Never - Always
In the last 6 months, how often did your health plan’s customer service staff treat you with courtesy and respect? Never - Always
Overall Ratings
Overall Ratings Using any number from 0 to 10, where 0 is the worst health care possible and 10 is the best health care possible, what number would you use to rate all your health care in the last 6 months? 0 - 10
Using any number from 0 to 10, where 0 is the worst personal doctor possible and 10 is the best personal doctor possible, what number would you use to rate your personal doctor? 0 - 10
Using any number from 0 to 10, where 0 is the worst specialist possible and 10 is the best specialist possible, what number would you use to rate the specialist? 0 - 10
Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health plan? 0 - 10

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The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.